| NPI | 1598116469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: SC 90083) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: FL ME151950) |
| 174400000X Specialist (Licence: FL ME151950) | |
| 208600000X Surgery (Licence: FL ME151950) | |
| 2086S0127X Surgery Trauma Surgery (Licence: FL ME151950) | |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2024-10-04 |